Each year in France, sperm donation allows couples to become parents. Like egg donation, sperm donation is governed by the law of bioethics and follows a series of very specific procedures, both on the side of the donor and on the side of the recipient couple.

Like any donation of elements of the human body (tissues, organs, gametes), sperm donation is governed by the law of bioethics. Like any donation, it is voluntary, free and anonymous. The donor and the recipient couple cannot know their respective identities, and the child born from the sperm donation cannot know the identity of the donor.

To be able to donate sperm, a man must meet certain conditions:

• be between 18 and 45 years old (no age limit is imposed by law but after this age, it is estimated that human fertility decreases and the risks of genetic abnormalities increase);
• to be in a good health ;
• have the agreement of the other member of the couple if necessary;
• since 2016 (1), it is no longer necessary to have a child to donate their gametes. A man who has never procreated can therefore now donate his sperm.

Sperm from donated sperm are intended for couples who cannot have children either because:

• the man does not naturally have spermatozoa (azoospermia) or a treatment (chemotherapy in particular) has affected his spermatogenesis;
• his sperm have severe abnormalities (severe OATS);
• the couple is at risk of transmitting a serious illness to the child.

When a man wishes to donate his sperm, he must contact a CECOS (Center for the Study and Conservation of Human Eggs and Sperms). Sperm donation is carried out only in these structures located in certain university hospitals. A donor can only donate in one CECOS.

The procedure involves different steps:

• a first information meeting: all questions relating to the donation are addressed;
• the consent : the donor signs a donation consent form, as well as the other member of the couple, if applicable. This consent can be revoked at any time until the use of the gametes;
• a medical check-up: this assessment includes an examination of the personal and family history, the determination of the blood group and rhesus, serological tests (hepatitis, HIV, CMV, syphilis), a genetic consultation and a karyotype by blood test;
• an interview with a psychologist for the donor and possibly the other member of the couple;
• a first collection of sperm : this collection, which sometimes takes place during the first appointment, makes it possible to check the characteristics of the spermatozoa and the absence of infection;
• freezing : the spermatozoa are packaged in straws, frozen, then transferred to liquid nitrogen at a temperature of -196 ° C. A straw is then thawed in order to assess the tolerance of the sperm to the freeze / thaw process. Depending on the results, the donor is informed of the number of collections to be made;
• the collections : each collection is carried out by masturbation after 3 to 5 days of sexual abstinence. The sperm is checked at each collection;
• a control blood test : At least 6 months after the last semen collection, serological tests are carried out again.

Only about half of the candidate donors are ultimately selected. The others are excluded mainly on the basis of genetic criteria; others because they do not take the blood test after the 6 months of quarantine.

All costs incurred by the donation are covered.

To be able to benefit from a sperm donation, the couple must meet certain conditions:

• be a heterosexual couple;
• be on the list before 39 years old for women, 57 years old for men. The age limit for benefiting from ART is set at 42 for women (with tolerance in certain cases, following the decision of the multidisciplinary team).

The donation request process is carried out in several stages, all organized by CECOS:

• a first interview : the couple requests a sperm donation from CECOS;
• an interview with a psychologist ;
• a consultation with a gynecologist to carry out an assessment and decide on the ART technique (insemination or IVF);
• additional exams (serologies, determination of the blood group, etc.);
• a request for consent medically assisted procreation requiring the intervention of a third party donor with the court or a notary.

In view of these different elements, the multidisciplinary commission validates or not the donation request. It can also request additional information before validating the request. Once the request has been validated, the waiting period for obtaining a sperm donation varies according to the CECOS, but also certain characteristics of the parents. It is on average 1 to 2 years.

Frozen sperm are stored until they are allocated to recipient couples. They can then be used as part of two AMP techniques:

• artificial insemination with donor sperm (IAD): The simplest technique of ART, artificial insemination consists of depositing in the uterus (intrauterine insemination) or at the level of the cervix (intra-cervical) the donor sperm previously prepared, 36 hours after the triggering of ovulation by ovarian stimulation treatment;
• in vitro fertilization : classical IVF consists in reproducing in the laboratory the natural stage of fertilization, by putting the oocytes previously collected from the woman (after ovarian stimulation) in contact with several sperm from the donor. One or two good embryos are then transferred to the uterus. Any supernumerary embryos can be frozen for subsequent TEC (frozen embryo transfer). IVF-ICSI (intracytoplasmic sperm injection) consists, at the stage of fertilization, in injecting a single sperm directly into the membrane of the oocyte, to optimize the chances of fertilization.

In 2014, 238 men donated sperm allowing the freezing of more than 11 straws. 378 children were born from sperm donation (1).

Adverse reactions

• for the donor, no adverse effects are to be noted. Its fertility is not impaired because the process of spermatogenesis is continuous and does not depend on a pre-defined stock;
• on the recipient’s side, the undesirable effects are those linked to ovarian stimulation and oocyte puncture.